State Fires Back on Claims Alleging Dangerous Conditions at Greystone

Lilo H. Stainton | June 28, 2019 | Health Care
Attorney general contends lawsuit fails to prove that state’s actions caused harm to plaintiffs

Greystone Park Psychiatric Hospital
A lawsuit alleging dangerous conditions at New Jersey’s Greystone Park Psychiatric Hospital has failed to link the state’s actions with harm to the actual patients named as plaintiffs, according to legal papers filed by the Attorney General’s Office late Wednesday.

In addition, the attorneys argued that the court shouldn’t force the state to take action immediately — before the case plays out in a trial — because the plaintiffs didn’t give them a clear road map with specifics on how to resolve the problems cited in their lawsuit. Moreover, doing so would disrupt patient care and could cause harm to other Greystone residents, the state said.

The attorney general’s brief is in response to the June 14 order from U.S. District Court Judge Esther Salas, in Newark, which gave the state less than two weeks to file paperwork explaining why claims filed by the New Jersey Office of the Public Defender didn’t deserve urgent attention; Salas also ordered the state to appear in court on July 18 to defend its actions.

But state attorneys Christopher Riggs and Francis Baker said the Public Defender was trying to “bypass the legal process and demand that a new standard of care be imposed without defining it or supporting it with competent evidence. Complying with such a radical and amorphous demand would not only be impossible for Defendants; it would be irresponsible,” they wrote in the brief.

The plaintiffs failed to meet the legal standard for immediate action for multiple reasons, the state said, and it promised to follow up with a motion to dismiss before the July 19 date to appear before Salas. “A preliminary injunction is an extraordinary remedy never awarded as of right,” they added, citing a federal case from 2008.

Serious allegations

In May, the Public Defender filed an amended version of a lawsuit, first submitted in December, on behalf of 11 current and former Greystone patients that alleged they and other residents risked imminent death or injury as a result of the state’s oversight at the psychiatric hospital. The suit — the first of its kind in nearly four decades — names as defendants Gov. Phil Murphy, Department of Health Commissioner Dr. Shereef Elnahal, Greystone CEO Tomika Carter, Attorney General Gurbir Grewal and other state officials.

The Public Defender’s filing included statements from doctors and other employees who claim overcrowding, insufficient staffing and faulty safety protocols have put patients and employees at risk, while eroding the quality of clinical care. One doctor claimed Greystone is “more of a zoo than a hospital” and that patients are treated like “animals”; others said state officials have continued to cover up the dangers that exist at the facility.

Greystone, in Morris County, is one of four state-run psychiatric hospitals that together house more than 1,200 individuals with serious mental illness and behaviors that can be dangerous to themselves or others; many are placed there by the court system. Constructed to house more than 550 individuals in a main building and cottages on the grounds, the hospital’s census had declined to 377 as of last week, according to the AG’s brief.

Several of these state psychiatric facilities have struggled to provide quality care at times — a consultant hired by the state also identified numerous challenges in a report issued in August — but Greystone has been a particular focus of concern in recent years. A handful of physicians and onetime board members at the hospital have repeatedly sounded the alarm about overcrowding and violence, which they say has gone underreported and unaddressed, charges reiterated in the lawsuit.

Under Elnahal’s leadership, the state parlayed the consultant’s report into an 18-month blueprint to reform the four-hospital system; it called for hiring more clinical staff, implementing best-practice standards, additional employee training, and physical upgrades to reduce ligature risks and other patient dangers. In May, DOH reported positive change was well underway, with more psychiatrists and advanced-practice nurses on the job, a lower patient count and fewer violent incidents.

A call for independent monitor

Despite these efforts, the Public Defender’s Office insists in its claims that Greystone patients remain at risk under the state’s care. In a motion filed in May calling for urgent court action, it asked the judge to force the state to immediately step up oversight and training, improve staffing levels and emergency protocols, and make additional physical changes at the Morris County facility. They also called for an independent monitor to be appointed to oversee the process.

The AG’s brief filed Wednesday takes issue with a number of these claims, noting that Greystone now employs 27 psychiatrists — more than double what it had a year ago — and 15 other doctors. Hanging risks have been addressed according to national standards, and emergency-response training has been provided, based on widely accepted protocols, it notes.

In addition, the state lawyers argue that the Public Defender failed to connect the dots between specific incidents and direct harm to the plaintiffs; “instead they improperly describe incidents involving patients who are not named in this action,” they wrote. As a result, they said the court should not grant their claim for immediate action.

The plaintiffs’ claim that the state’s poor oversight and mismanagement created a danger to the plaintiffs is not valid, the AG’s brief notes, because the law requires public officials to have done something wrong or to have misused their authority — not just fail to take action — for them to be found at fault. In addition, the defendants’ role must have a direct connection to the plaintiffs’ danger, which it said is not established in this claim.

The AG’s office also found fault with the statements provided by doctors and other employees — some of whom no longer work at Greystone and therefore cannot speak to the potential danger that currently exists, it said — arguing these should be excluded entirely by the court. These briefs are more about promoting the personal interest of certain staff members, the state suggested and are filled with “editorialized opinions” and personal conclusions, not factual evidence or claims that relate directly to the plaintiffs’ case.

“The ‘whistleblowers’ cannot use this action as a vehicle to litigate their private employment grievances, nor are such grievances sufficient to establish irreparable harm to the named Plaintiffs,” the AG’s office wrote.

Both the AG and the Public Defender declined to comment further on the filings Thursday.